Individual provider Active NPI

Hadiel Mutlak, D.D.S

  • Dentist
  • Franklin, TN
National Provider Identifier
1154304293
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8268 Issued in TN
Practice address
1010 Murfreesboro Rd
Suite 196
Franklin, TN 37064-3000
Phone
(615) 794-0402
NPI assigned
Nov 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8268 TN Primary

Addresses

Primary practice location

1010 Murfreesboro Rd
Suite 196
Franklin, TN 37064-3000

Mailing address

1010 Murfreesboro Rd
Suite 196
Franklin, TN 37064-3000
Phone (615) 794-0402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160113002204 TN Order and Referring Only - DentistPractitioner - Dentist 5092017640

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Castle Mid-South Dental Centers Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154304293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 MURFREESBORO RD",
            "address_2": "SUITE 196",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370643000",
            "telephone_number": "615-794-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 MURFREESBORO RD",
            "address_2": "SUITE 196",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370643000",
            "telephone_number": "615-794-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUTLAK",
        "first_name": "HADIEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "8268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin, TN

Sources for this page

Verify at the official NPI Registry.